A Tragedy Named Placenta Accreta

I had already defeated breast cancer. Yep, you heard it right- I had kicked cancer’s ass to the curb and had already endured months of surgery, chemo, and radiation. I was so convinced that any type of health complication was behind me and that anything in comparison to cancer was completely inferior to that experience.

My pregnancy was an amazing but nerve wracking surprise. I had just finished my cancer regimen and was in the beginning of the “calm” when the storm hit again. This storm, however, was a bit more pleasant. It was the type of thunderstorm that occurs when you are already safely tucked in your bed, the fear of thunder is long gone with your accumulating aging years, and you can fall asleep to the beating rain on your roof in a relaxed, comfortable state.

I loved being pregnant. Most of this attitude had to do with the fact that I never thought I’d get to be the woman with a cute, pudgy pregnant belly. I never thought I’d get to feel the kicks, experience the discomfort as the months progressed, and wear all of the cute maternity clothing. I never thought I’d get to talk about this excitement with other people and parents.

I was stoked- I was part of the club I never thought I’d gain entry to. I sailed through the pregnancy with ease and only had gestational diabetes as a complication mostly due to genetic factors. I figured, NOTHING could be worse than cancer. I had beaten it and kicked its ass far across the world from where I stood. Therefore, gestational diabetes really did not bother me. I followed the diet and recommendations and I was fine.

Finally the day came- it started with an induction and after baby’s heartbeat started to drop, I was sent in for a c-section. This wasn’t my plan, but I wanted baby to be healthy and my plan took a back seat once I saw that heartbeat drop.

The C-section went well. I heard my son crying as they removed him from me and breathed a sigh of relief. My husband left with him to cut the cord and I was anxious to get to my room and baby. I soon realized I was growing a little bit concerned as it seemed as though the surgeon was taking forever to complete the surgery. I sat there and wondered if everything was okay but nothing was said to me- I was too scared to ask. After what seemed to be at least 45 minutes, the surgery was over and I heard the surgeon say loudly into her recording of the time and the diagnosis: Placenta Accreta.

Now, if you’ve been diagnosed with Placenta Accreta, you will know why it can be such a scary event. First of all, you have no idea that you have it until you give birth. It cannot be detected on ultrasound (although they say it can be through this and MRI but mine was not detected at all). I found this out the hard way again with my second son’s birth but we will get to that later. Secondly, you can bleed to the point where a blood transfusion is necessary. Thirdly, the condition can result in an IMMEDIATE hysterectomy (or damage to the uterus) which for most women can be devastating if there is the desire to add future babies to the family, and lastly, you can flat out die.

What is this condition that can cause this array of potentially devastating results? Placenta Accreta is a condition in which the Placenta literally infuses itself to the uterus during the 9 months your baby is developing. The blood vessels and other parts of the Placenta grow deeply into the uterine wall and prevents the Placenta from detaching naturally as it is supposed to after the baby is born and can cause a life threatening situation.

Devastating right? We don’t hear much about this condition but it accounts for about 75% of all complicated cases according to the American Pregnancy Association. This appears to be a lot of women affected by this potentially dangerous complication.

My OB surgeon managed to save my uterus during that surgery. I was so grateful after she explained the severity of the condition as we knew we wanted one more baby. Because she did such a stellar job saving it the first time, I decided to use her as my surgeon again during my second birth and scheduled c-section.

During the second pregnancy, I was given the platinum card level of care- I had many ultrasounds, and other extra appointments to try and detect another case of Placenta Accreta because once you have had it, you are at higher risk of being the unlucky person who can have it again during future childbirths. All ultrasounds pointed to just what I wanted to hear: no signs of reoccurrence.

The day of that second c-section finally arrived. I was excited to meet my second son and the day couldn’t come fast enough as this pregnancy was a lot more uncomfortable with daily painful contractions and more gestational diabetes. I was ready to have my second child, and move forward with great health.

I again heard my son crying as they removed him and carried him off. I knew something was wrong again when they had initially said that I would be able to have immediate skin to skin with my baby and suddenly… that didn’t happen. I was less afraid this time and asked over the curtain, ” how’s my Placenta?” The response was not what I wanted to hear. “It’s stuck again, Marla,” reported my OB surgeon.

It was devastating and immediately anxiety provoking. I now knew that she was actively trying to pry my stuck Placenta off of my uterus with the threat of an immediate hysterectomy. I know I was already set on not having any more children at this point, but I had already put my body through enough with cancer and the lack of control I had with in the end being left with a marred Breast. I was upset I would again lose a body part due to my body somehow working against me and taking control away from me in terms of decision making.

I will never forget staring up at the ceiling and seeing one metal strip reflecting my surgeon trying to pry my stuck Placenta off of my uterus and what later would result in a more serious issue.

My surgeon sutured my wound, but noticed my catheter bag was filling with blood. They monitored and tried to flush it for about an hour after surgery. The bleeding did not stop and away I went back into the OR while being robbed of the time I was supposed to spend with my newborn.

After a 4 hour surgery, I was told that during the process of trying to remove my Placenta, the surgeon did not notice that my bladder was also stuck to my Placenta and when using an instrument to remove my Placenta from my uterus, lacerated my bladder in the process so badly that it was barely hanging together. I was basically internally bleeding and I had no idea until they brought me back into an intubated surgery that lasted four times as long as my c-section.

As a result, not only was I damned with a second round of Placenta Accreta that day, but a lacerated bladder, double abdominal surgery and an unclear prognosis in terms of being able to use the bathroom on my own ever again. I was sent home with an indwelling catheter, a brand new baby, immediate depression and a huge double abdominal wound.

My overall point: Placenta Accreta is not only a life threatening complication on its own, but can cause other complications as well as it did in my case. The tragedy of it all is that many women who aspire to have more children can’t and many may suffer on-going or future issues related to these previous complications that may result in future surgeries and treatments. My pregnancy had a high amount of surveillance, but this still couldn’t accurately tell me that I had this condition again. I realized much later if I would have attempted to have vaginal child births, I could have died due to blood loss or internal damage as they tried to naturally pull my Placenta through the birth canal.

In the end, the catheter eventually came out however I was left with half of a bladder and some complications related to this. I have yet to see over time how my body has been affected by this and let me tell you, it’s a torturous waiting game.

The tragedy of Placenta Accreta can hopefully over time change to a story with a healthier ending. Medical providers can hopefully find a real tool to detect this condition and prevent this condition from threatening lives so that mothers can live to be the mothers they were meant to be and have the children that they hope to have after enduring this condition.

Talk to your medical provider if you’ve had the condition and plan to have more children- use as many tools as possible to monitor the likelihood of having a reoccurrence with this condition so your doctors can at least be prepared and talk more openly about the risks and complications that can occur.